Single access laparoscopic colorectal surgery: lights and shadows.
2012
Introduction: To minimize the complications related to conventional multiport
laparoscopic surgery, the single access laparoscopic surgery has been
developed. Some results of case series and case-controlled studies are
supporting the feasibility and safety of Single Access Laparoscopic Colectomy
(SALC). Materials and Methods: Since January 2009 we performed all kind of
colorectal procedure by a single access laparoscopic approach. We began with
right colectomy that represent the only procedure in which we did not
reproduce the same surgical steps of multiport laparoscopic surgery. In
contrast, we reproduce the same surgical technique of multiport colorectal
resection during a left or rectal single access laparoscopic procedure as
well as total colectomy. Conclusion: About the transferability of SALC,
programs of training need to focus on safety and techniques. We believe that
only high laparoscopic skills surgeon can perform SALC. It’s mandatory to
evaluate outcomes and cost-effectiveness of SALC respect to multiport
laparoscopic colectomy using randomized trials.
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